Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ - Brasil.
Arq Bras Cardiol. 2023 Nov 10;120(8):e20220832. doi: 10.36660/abc.20220832. eCollection 2023.
Previous studies have identified inequalities in the variation of mortality rates from ischemic heart disease (IHD) and cerebrovascular disease (CBVD) when comparing regions with different levels of socioeconomic development indicators.
To analyze the variation in IHD and CBVD mortality rates and economic development, evaluated by the sociodemographic index (SDI) and social vulnerability index (SVI) in Brazil over a period of 20 years.
Ecological study of time series of crude and standardized mortality rates (direct method, based on the Brazilian population in year 2000) from IHD and CBVD by sex and Federative Unit (FU) between 2000 and 2019, compared using the SDI and SVI.
There was an improvement in SDI and SVI concomitantly to a reduction in age-standardized mortality rate from IHD and CBVD in the country; however, this occurred unevenly across the FUs. The FUs with the best socioeconomic indicators had the greatest reduction in mortality rates.
The variations in mortality rates from IHD and CBVD, compared using variations in socioeconomic development, are aligned with those from previous studies, but the present study goes further by including the indicators SDI and SVI in the comparison. The limitations include the observational nature of the study, the use of databases, and the vulnerability to ecological bias.
The observed data raise the hypothesis that the improvement in socioeconomic conditions is one of the factors responsible for the reduction in mortality rates from IHD and CBVD.
先前的研究已经发现,在比较具有不同社会经济发展指标水平的地区时,缺血性心脏病(IHD)和脑血管疾病(CBVD)的死亡率变化存在不平等现象。
分析 20 年来巴西 IHD 和 CBVD 死亡率与经济发展的变化,采用社会人口指数(SDI)和社会脆弱性指数(SVI)进行评估。
这是一项关于 2000 年至 2019 年期间按性别和联邦单位(FU)划分的 IHD 和 CBVD 粗死亡率和标准化死亡率(直接法,基于 2000 年巴西人口)时间序列的生态学研究,比较使用 SDI 和 SVI。
SDI 和 SVI 均有所改善,同时 IHD 和 CBVD 的年龄标准化死亡率也有所下降,但各州的改善情况并不均衡。社会经济指标最好的 FU 的死亡率降幅最大。
使用社会经济发展变化来比较 IHD 和 CBVD 的死亡率变化与先前的研究结果一致,但本研究更进一步,将 SDI 和 SVI 指标纳入比较。研究的局限性包括观察性研究性质、数据库的使用以及易受生态偏差影响。
观察到的数据提出了这样一种假设,即社会经济条件的改善是导致 IHD 和 CBVD 死亡率下降的因素之一。